New Treatments for Migraines Sufferers
An estimated 39 million Americans experience migraines — that’s more than 1 in 10 people. People of all ages, including children, can develop this disabling neurological condition. They experience recurring intense throbbing or pulsing head pain, sometimes accompanied by nausea, an aura, and light and sound sensitivities.
From the community: “I have had migraines all my life. I have learned to live with and deal with many of them but every so often there are the ones that don’t respond to anything or are significantly disabling. I often have them for several days in a row. Before getting my B12 shots and taking some specialized iron I had them daily for 3.5 months straight.” – Inspire member
Migraine prevalence and types
Experts think the number of people living with migraines may actually be higher than 1 in 10 —many people live with the pain and don’t seek treatment. It’s not uncommon to experience an occasional migraine. But some people have frequent migraines: Chronic migraine is defined as 15 or more episodes in a month, and episodic migraines can occur as often as 14 times each month.
According to some experts, fewer than half of people with migraines (40%) get adequate symptom relief from medications. More than 800,000 emergency department visits each year are people seeking relief from extreme migraine pain.
The impact of migraines
Extreme head pain can make it difficult for people to function at their best – whether they’re at work, school, or with family and friends. Migraine sufferers can spend more than half of every month experiencing head pain so excruciating that it interferes with their ability to enjoy life.
A 2021 Migraine in the Workplace survey conducted by the HR Research Institute and Aimed Alliance found that close to 9 out of 10 employed migraine sufferers say the condition negatively impacts their ability to do their jobs. Workplace absenteeism (calling out sick with a migraine) or presenteeism (not performing well at work) affects the employee and their employer.
There’s also a link between migraines and mental health issues. An estimated 2 out of 10 people with episodic migraines, and nearly half of those with chronic migraines, develop depression or anxiety. The stress brought on by migraines can affect every facet of a person’s life. Fortunately, recently approved migraine medications offer help and hope.
From the community: “omg- yes, i get terrible, frequent migraines. am so sorry you do as well; it’s the worst… my FMD neurologist rx.ed butabital (fiorinal with aspirin) and it’s been a life saver. it doesn’t always ‘cure’ it completely, but helps enough so i don’t have to take too much imitrex, and really allows me to function on days that i call ‘1/2 a migraine’ (bad, but not debilitating/bedbound-making).i think there are warnings about addiction to this med (though it is not an opiate), but i have never had an issue with it and have never wanted/needed to take it when migraine was not happening.” – Inspire member
New medications for migraine pain
Since 2018, the U.S. Food and Drug Administration (FDA) has approved eight new migraine-specific medications. Many earlier migraine medications weren’t intended to treat head pain. They were developed to treat other conditions like epilepsy, high blood pressure, or depression. But these new classes of drugs are expressly designed to treat migraine pain. Some of the new medications prevent migraines, while others provide improved pain relief with fewer medication side effects.
The treatments belong to a newer class of preventive medications called calcitonin gene-related peptide (CRGP) inhibitors. These drugs release monoclonal antibodies that block CRGP, a protein in the brain that triggers a migraine.
The first CRGP inhibitor, ubrogepant (Ubrelvy®), has been on the market since 2019. The oral pill treats the acute onset of migraines. It was followed by rimegepant (Nurtec ODT) in 2021, a dissolvable pill that treats acute migraines and prevents episodic migraines.
Three other approved CGRP medications — erenumab (Aimovig®), fremanezumab (Ajovy®), and galcanezumab (Emgality®) — require monthly self-injections, while eptinezumab (Vyepti®) requires an injection every three months by a healthcare provider. There’s also lasmiditan (Reyvow®), an oral medication that belongs to a different class of drugs known as ditans. Lasmiditian is approved for the treatment of acute migraines.
From the community: “I get migraines every day. Been diagnosed with chronic daily migraine without aura. the problem is that none.of the meds work…and I’ve tried them all. I’ve been left with fioricet with and without codeine. From there I have to move to narcotics. I don’t like it, but that’s my life…” – Inspire member
The most recently approved migraine drug on the market, atogepant (Quilipta®), is a once-daily oral medication for the prevention of episodic migraines. In the Phase 3 ADVANCE clinical trial for atogepant, participants saw a greater than 50% reduction in monthly migraines. The FDA approved the drug in September 2021.
From the community: “it’s an oral dissolve tablet, should work fast. It works by blocking CGRP receptors; this is a new class of migraine drugs.. it’s highly unlikely the doctors are pushing it for financial gain because drugs like Aimovig and Ajovy have been successful and they are the newish CGRP meds in injection form. Sumatriptan increases serotonin primarily, that then effects CGRP receptors but the triptans can be less effective than the new CGRP blocking drugs.” – Inspire member
While these newer medications offer migraine sufferers a much-needed respite from pain, their newness also means they’re more expensive than generic triptans or earlier migraine medications. Despite the increased cost, research indicates that the effectiveness of CRPG inhibitors in decreasing migraines actually makes them as cost-effective as other migraine treatments.
There are numerous clinical trials underway to find new and better ways to prevent and treat migraines. These clinical trials are critical for expanding treatment options for migraine sufferers and helping them get back to enjoying life.
Learn more about how Inspire can improve awareness about clinical trials.
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1 https://americanmigrainefoundation.org/; https://americanmigrainefoundation.org/resource-library/what-is-migraine/; https://medlineplus.gov/migraine.html; https://pubmed.ncbi.nlm.nih.gov/28017235